A blend of two therapies for stage four melanoma.

In recent years, cancer treatment has evolved to an extent that now tumour-specific therapies known as
targeted therapy are being utilized that attack molecules present in respective cancer cells. Additionally,
immunotherapy has been thriving as well, which focuses on enhancing an individual’s immune system to
eradicate tumour cells as these cells seem to suppress immunity via various mechanisms. An example of
such mechanism is a cell group known as suppressor cells from myeloid tissue (MDSC). In order to
conquer this group of cells, the discovery of all-trans-retinoic acid (ATRA) drugs took place. Often, a
combination of these medications is used as an effective treatment regimen. Along the same lines, a new
study published in the clinical cancer research journal promises to treat last-stage melanoma (skin cancer)
by combining chemotherapy and immunotherapy. Cancer starting from the pigment-making cells of our
skin is referred to as melanoma which gets highly invasive as it grows and advances. The researchers of
this study conducted a phase 2 trial to test a drug combination containing pembrolizumab and all-trans-
retinoic acid against melanoma stage four.

Twenty-four individuals with advanced-stage melanoma participated in this experiment; half received
both medications, while others had only received pembrolizumab. All of the participants didn’t receive
any immunotherapy before. Seventy-one of the patients who took both medications reacted favourably to
the course of therapy, with half exhibiting a full recovery and eighty per cent with successful one year of
survival following the therapy. In contrast, the outcome ratio to immunotherapy only was about forty per
cent. The amounts of circulatory MDSCs receded significantly as well. The experiment also examined the
side effects, where the ATRA-receiving individuals experienced headaches, lethargy, along with vomiting
following the primary doses.

As cancer advances, treatment options become narrower, as is with the advanced cases of melanoma.
Some patients often get resistant to therapies such as chemo and immunotherapy, which pose a significant
challenge for medical science. By discoveries of such drug combinations, new areas of development are
unlocked that will eventually help in the treatment of such patients. This drug, for example, proved to be
successful, efficient and less toxic compared to the other options currently used. Although, it will take
years to legalize it as the study now proceeds to its phase 2 stage with a larger sample size. Nevertheless,
another takeaway from the study is MDSCs and how by targeting them, the treatment efficacy can be
uplifted.

References

1. Tobin, R. P., Cogswell, D. T., Cates, V. M., Davis, D. M. and et.al (2023, April 1). Targeting
MDSC Differentiation Using ATRA: A Phase I/II Clinical Trial Combining Pembrolizumab and
All-Trans Retinoic Acid for Metastatic Melanoma. American Association for Cancer Research.
https://doi.org/10.1158/1078-0432.CCR-22-2495